Payer Roundup—North Carolina pays out $6B in Medicaid contracts

North Carolina officials have reached agreements with five insurers to offer Medicaid managed care in the state, with the deals totaling $6 billion. The insurers—AmeriHealth Caritas, Blue Cross and Blue Shield of North Carolina, UnitedHealthcare, WellCare and Carolina Complete Health, a consortium of Centene Corp. and state provider groups—will be paid a flat fee per beneficiary per month and can share in profits if costs are kept low but will face a loss if costs run over. It’s the largest amount ever spent by the state’s Department of Health and Human Services. The updated Medicaid program will be rolled out in geographical phases. North Carolina also rejected a proposal from the state’s 12 largest health systems to run its Medicaid program, much to the frustration of patient advocates. “I was very surprised that the hospitals’ bid was rejected, and that two plans that have no real North Carolina experience and bad track records in other states were accepted instead,” said Douglas Sea, senior attorney at the Charlotte Center for Legal Advocacy.